Evidence of meeting #41 for Health in the 41st Parliament, 2nd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was e-cigarettes.
A recording is available from Parliament.
12:40 p.m.
Conservative
Terence Young Conservative Oakville, ON
So as well as being a heart surgeon, you sell many brands of e-cigarettes and you even have your own brand. Isn't that correct?
12:40 p.m.
Cardiovascular Surgeon, Trillium Cardiovascular Associates, As an Individual
That's correct, sir, yes.
12:40 p.m.
Conservative
12:40 p.m.
Cardiovascular Surgeon, Trillium Cardiovascular Associates, As an Individual
In the retail store, where we can verify age, we do.
12:40 p.m.
Conservative
Terence Young Conservative Oakville, ON
I was under the impression that this was illegal in Canada. Is it not illegal?
12:40 p.m.
Cardiovascular Surgeon, Trillium Cardiovascular Associates, As an Individual
I can only go with our legal advice, sir. We've been in contact with Health Canada, and our legal advice in Toronto has told us that this is up for debate. We do not sell it on our Internet site, because we cannot verify the age.
12:40 p.m.
Conservative
12:40 p.m.
Cardiovascular Surgeon, Trillium Cardiovascular Associates, As an Individual
That's correct; yes, sir, it is.
12:40 p.m.
Conservative
Terence Young Conservative Oakville, ON
I just want to ask you whether you recognize any potential conflict of interest in being a heart surgeon and medical doctor and also selling and profiting from selling an addictive product.
12:45 p.m.
Cardiovascular Surgeon, Trillium Cardiovascular Associates, As an Individual
That's fair enough, sir; it's a very good question.
If it causes no cardiovascular harm.... As I said, when I was approached, from a purely business perspective, I spent six.... When somebody mentioned electronic cigarettes to me, I was completely ignorant of it, two years ago. My initial reaction was that I'm not going to involve myself in anything like this. I spent six months taking a look at the data myself—reading the original studies, not relying on interpretation.
12:45 p.m.
Conservative
Terence Young Conservative Oakville, ON
I've heard your evidence that they're much safer than tobacco—
12:45 p.m.
Cardiovascular Surgeon, Trillium Cardiovascular Associates, As an Individual
Yes.
12:45 p.m.
Conservative
Terence Young Conservative Oakville, ON
—and that for people addicted to tobacco it's a good alternative. But what about young people who aren't addicted to anything but might have their first addiction to these products? That's my concern.
12:45 p.m.
Cardiovascular Surgeon, Trillium Cardiovascular Associates, As an Individual
That's fair enough.
12:45 p.m.
Conservative
Terence Young Conservative Oakville, ON
In your conclusion, you say that “flavoured e-cigarettes products are not being produced to target a youth market”.
Please read our report when it comes out, and please take a look at the evidence that's online, because that's not what we've heard. We've heard that youth are being targeted with various flavours of products, targeted directly. Marlboro now has a product out, a hybrid between a vaping product and a tobacco product, that they're marketing. They're marketing it to youth through movies and television with product placement, which is a very insidious form of marketing.
So your conclusion there is actually incorrect.
12:45 p.m.
Cardiovascular Surgeon, Trillium Cardiovascular Associates, As an Individual
Well, sir, the way flavouring is used in marketing can be regulated. I certainly would agree 100% that any representation of the use of tobacco to youth as a cool thing, as a lifestyle thing, be completely off limits.
12:45 p.m.
Conservative
Terence Young Conservative Oakville, ON
A previous witness said that you could make it with flavours that children don't like or something, but I don't know how you could market a product with flavours that children don't like but adults do. People like flavours, whatever they are. I don't understand that position.
12:45 p.m.
Cardiovascular Surgeon, Trillium Cardiovascular Associates, As an Individual
I can extrapolate from data in jurisdictions in which flavours are freely available, and the actual use of electronic cigarettes by youth is exceptionally low. It's less than 0.1% in a huge population study in Germany.
We can emphasize the small use of electronic cigarettes by youth or we can choose to see that the real problem is that 14% of youth are getting hooked on tobacco cigarettes and that this what is going to kill them when they're 25 and 30 years old.
12:45 p.m.
Conservative
12:45 p.m.
Conservative
The Chair Conservative Ben Lobb
Mr. Young, your time is up, sir. I'm sorry.
Ms. Fry, it's your time now.
12:45 p.m.
Cardiovascular Surgeon, Trillium Cardiovascular Associates, As an Individual
No addictions is always better, but it's not practical.
12:45 p.m.
Liberal
Hedy Fry Liberal Vancouver Centre, BC
Thank you very much, Mr. Chair.
I think I'm going to have to stop drinking coffee because it's addictive. I don't know what we can do. We can ban it, or something like that, and Coke and Pepsi and all of the other addictive drinks that our children drink that will cause them to get diseases like type 2 diabetes, etc.
I think that discussing addiction is about whether addiction is harmful, whether it causes you disease and illness, or whether that addiction, at the end of the day, has no effect on the rest of society or on your own particular health.
Given the fact that we've heard over and over that nicotine itself has an effect in terms of disease and harm done, in the same way as coffee.... I'm hearing that coffee has benefits to a lot of people. I think the important thing therefore is that you're talking about e-cigarettes as harm reduction in the same way that we use a patch and the gum, which are all legal things to use and are prescribed by physicians to use them. We hear that those harm reduction methods are not particularly effective.
Again I want to congratulate you, Dr. Bhatnagar. You and the earlier physician who presented to us gave us some facts we did not have before that I cannot refute—they come from reliable sources—about the benefits and the second-hand smoke issues, and all of those kinds of things. Given that I believe what you're saying about e-cigarettes, it may be worth using it as a harm reduction technique, an effective way to stop smoking, and an effective way to save lives, as we're hearing.
You're suggesting regulations, and I agree with you. Right now it's in a limbo world where anybody can sell it, anybody can buy it, and nobody knows what quality they're getting, either the industrial quality or the quality and potency of the nicotine, etc.
You've given us a list of the things that you believe should be put into regulations, i.e., sales to minors, advertising. I was told earlier on that we could use childproof bottles or vials for containing the nicotine.
What I wanted to ask you is this. Are you suggesting that this be treated as a consumer product or are you suggesting that it be a prescribed product? That's the first question I'd like to ask. Because I think that again is where it falls. Should it be prescribed by physicians in the same way that the gum and the other harm reduction techniques used for smoking cessation are? If so, how would you do that? Would it have to be a specialist in tobacco cessation? Would you do that? Or would your family doctor do it? Or could a nurse do it, if you're in a smoking cessation program?
I am convinced from all of the studies except the Polish study—and you can't just pick one study—that actually this does not cause “re-normalization of smoking”. My big question is, should it be sold behind the counter in a pharmacy? Or should it be given as a prescription?
Mr. Sweanor, I wanted to applaud when you finished. You gave some extremely graphic descriptions that I could just imagine—people grinding up coffee beans, and rolling it and smoking it, you know? I think you effectively made the point that it's the mode of transition that is the problem, not nicotine itself. When you take away all the tar, nicotine, formaldehyde, and all that kind of thing, you take away the harm that is being done by the drug.
Again, I just wanted to suggest to you, as a lawyer, whether you see pieces of legislation other than the ones we heard about, minors, etc., that you think would help.... Should there be warnings? Should there be any kind of thing sold with the cigarettes that you feel might help to make better public health legislation and public health policy?
Thank you.
12:50 p.m.
Conservative
The Chair Conservative Ben Lobb
I'd just like to ask you both for a brief response. It's going to be tough to do because we were pretty much five minutes getting there.
12:50 p.m.
Adjunct Professor, Faculty of Law, University of Ottawa, Special Lecturer, Epidemiology and Public Health, University of Nottingham, England, As an Individual
The quick answer on regulation is Clive Bates' submission, that you have, because he gives a very good overview of what would be necessary. In short, we want to make sure these products are not placed at a disadvantage to cigarettes. We want the less hazardous products to be the more available products.
We also want to ensure that our fear about unintended consequences, such as children getting access to these.... Keep in mind that 80% of smokers say, “I wish I didn't smoke”. Where are kids getting their cigarettes? They're getting their cigarettes from family, people who don't want to smoke. If we could get them off smoking, we would get rid of a lot of the access that gets kids started. There's huge potential upside on this. We just need to be sensible on the regulation and avoid things like “medicinalizing” it so that cigarettes are given an advantage in the marketplace.